Endometriosis
Endometriosis affects one out of every seven Australian women. Despite being so common, unfortunately it takes over six years on average to be accurately diagnosed, significantly delaying treatment and prolonging the battle with painful periods, debilitating fatigue, and infertility.
What is endometriosis?
Endometriosis is a condition where the tissue similar to the lining of your uterus (the endometrium), grows in other areas within your pelvis. Common locations for endometriosis include around your ovaries, fallopian tubes, and outer surface of your uterus, but abnormal tissue growth can even be found around your bladder and bowel.
Like the normal endometrium inside your uterus, this tissue responds to your monthly hormonal cycle, thickening then breaking down during your menstrual period. However, as this blood has nowhere to go, it results in chronic inflammation, scarring, adhesions, and severe pain. Most women with endometriosis are diagnosed in their 20s or 30s, but even teenagers can be diagnosed with it, too.
Why is endometriosis so difficult to diagnose?
Studies have shown that women living with endometriosis take an average of 6.5 years before their symptoms are accurately recognised as endometriosis. Part of this delay is because many women view period pain as normal and don’t seek help from a specialist to investigate their symptoms further. The symptoms of endometriosis can also be difficult to recognise, even for some healthcare professionals.
Another barrier to timely endometriosis diagnosis is that there is no simple test to confirm this condition. The current standard for diagnosing endometriosis is through a keyhole surgical procedure called laparoscopy, which requires additional specialist gynaecology training to perform. Fortunately, there has been growing awareness among both the public and healthcare professionals about this debilitating gynaecological condition, slowly reducing the lengthy delay to a conclusive endometriosis diagnosis in Australia.
What causes endometriosis?
The exact causes of endometriosis aren’t well understood, but doctors believe the condition is influenced by genetic, hormonal, and immune factors. There are many theories about the underlying cause of endometriosis, but no one theory can explain all the symptoms or findings.
You may be at a greater risk of developing endometriosis if:
- You have a first-degree family history of endometriosis
- Started your period at an early age (at 12 years old or younger)
- You have never been pregnant before
- You get heavy periods
Symptoms of endometriosis
The symptoms of endometriosis are non-specific, meaning many other different and unrelated conditions can present with similar symptoms. Endometriosis symptoms can also be quite variable from individual to individual.
The most common symptoms of endometriosis include:
- Severe and debilitating period pain
- Heavy or irregular periods
- Painful sexual intercourse
- Fatigue
- Infertility or subfertility
- Generalised pelvic pain
- Pain radiating to your back, upper thighs, or buttocks
- Bloating
- Pain with urination
- Painful or abnormal bowel motions during your menstrual period
Not all women with endometriosis will experience symptoms. Some endometriosis symptoms may also be misdiagnosed or attributed to another condition, such as uterine fibroids, pelvic inflammatory disease, ovarian cysts, or inflammatory bowel disease, irritable bowel syndrome, or chronic bladder inflammation.
Endometriosis surgery with Dr Sam Daniels
Though all gynaecologists are familiar with endometriosis, not all have undertaken the additional training in advanced laparoscopic techniques to diagnose and treat this life-altering condition. Dr Sam Daniels has a specific interest in the management of endometriosis, and is accredited to perform the highest level of complex surgery, including endometriosis excision treatment.
Endometriosis is a chronic condition, and while there is no cure, the right treatment can be effective at reducing your symptoms and allowing you to enjoy life without the constant monthly cycle of debilitating pain.
Endometriosis surgery
Laparoscopy is a minimally invasive surgical technique that can be used to diagnose and treat a number of gynaecological conditions, including endometriosis. Endometriosis can also be surgically treated with robot-assisted surgical techniques. Both approaches require additional specialist training to perform.
Laparoscopy and robotic endometriosis surgery involve creating very small incisions in your abdomen. A long, thin tube equipped with a light and camera at the end can be inserted into one of these incisions, which allows Dr Sam to look for endometriosis and assess the severity of the condition. At the same time as his investigation, the laparoscopic technique gives him the opportunity to simultaneously address any problems he finds.
Surgical excision aims to remove the abnormal endometrial tissue growth, treating your symptoms and improving fertility. Dr Sam can also treat scar tissue and pelvic adhesions (abnormal connections between organs and structures that are usually separate) during the laparoscopic procedure. Surgery for endometriosis is currently the gold standard for treatment.
Non-surgical treatment of endometriosis
You may consider off-the-shelf pain relief medications such as paracetamol or ibuprofen to manage endometriosis-related pain, though not all women find these medications effective.
Dr Sam may recommend a hormone treatment, which aims to reduce your pain and discomfort while suppressing the hormones that exacerbate your symptoms. Many of these endometriosis hormone treatments you may know as contraceptives, including the oral contraceptive pill, contraceptive implant under the skin, or intrauterine device (IUD).
Non-surgical treatments for endometriosis can be used alongside surgical options, but should not be used if you’re trying to fall pregnant.
Frequently Asked Questions
If you have endometriosis symptoms, your first port of call would be with your GP. Based on their experience in managing endometriosis, or if you haven’t yet been properly diagnosed, they will refer you to a gynaecologist. A gynaecologist can confirm an endometriosis diagnosis and offer specialist management, whether with hormone therapy or surgery.
Endometriosis can make it difficult to fall pregnant by causing scarring and distortion of your reproductive anatomy through adhesions. The chronic inflammation and abnormal tissue growth can affect egg quality and numbers, while also having an impact on implantation of a fertilised egg in your uterus. Despite the negative effects of endometriosis on fertility, you may still go on to conceive successfully after surgical treatment of endometriosis or with assisted reproductive technologies such as in vitro fertilisation (IVF).
Dr Sam is a gynaecologist with a special interest in endometriosis. His advanced surgical training enables him to provide high-precision endometriosis surgery via laparoscopic or robotic techniques, with excellent clinical outcomes.
Specialist care for women’s health concerns
Comprehensive care with Dr Sam Daniels is available across multiple Sydney locations, including urgent gynaecologist appointments for time-sensitive cases.